As you age, you have passed through all phases of life. You saw the child in you, who had no worries. You see the adolescent, who had confusion. You saw the youth, who had all the energy and responsibilities. You also saw the middle age when you realized that you are losing the vigor you had once. In the old age, when you have retired from the social responsibility, you tend to ponder upon the quality of life you have lived till now.

Erik Erikson, a German-American psychoanalyst, explained about the stages of psychosocial development in the 1950’s. It posits eight stages, and the eight stages is the old period, which consists of integrity vs. despair. Either the individual in the old age goes through despair or integrity according to how they thought they lived or contributed, or their quality of life. While the feelings of integrity can make one flourish and contribute more, feelings of despair takes away the opportunity to see the positive events in one’s life.

The quality of life has direct impact on mental health and the older adults and their mental health is often ignored and considered as the part of the ageing process. However, there are many factors that are responsible for mental health issues in the old age and every factor has a different impact on the nature of problems faced. Some of the factors are:

• Retirement from professional life.
• Loss of partner
• Limitations in functioning caused by biological maturing
• Loss of social support
• Physical illness
• Prior mental illness
• Elder abuse

Nature of mental health issues in the old age can be mild to severe, which might be acute to chronic requiring attention and care to reach out for an online counselor, choice of which would differ from person to person and the personal, social, economical factors. Depression, anxiety and dementia are the most commonly experienced mental illnesses/disorders in the old age, which further deteriorates the quality of life.

Some of the severe psychiatric disorders in old age are depression, anxiety, dementia, delirium, Obsessive Compulsive Disorder and psychosis.

50 million people worldwide are estimated to have dementia with approximately 60% residing in low- and middle-income countries. The total number of people with dementia is likely to increase as much as 82 million in 2030 and 152 million in 2050.

Reports suggest 7% of the elderly population suffer from unipolar depression, which accounts for 5.7% of years lived in disabilities among those over 60 years old.

A recent study from the International Journal of Geriatric Psychiatry found that more than 27% of older adults receiving care from an ageing services provider have anxiety symptoms that may not be severe enough to warrant a diagnosis of a disorder but have a significant impact on their functioning. Between 3% and 14% of older adults meet the criteria for a diagnosable anxiety disorder.

An estimated 5.0 million persons over the age of 65 had dementia in 2014, and that number is expected to rise to approximately 14 million by the year 2060.

An estimated 14-56% of elderly hospital patients suffer from delirium. In the US, at least 20% of the 12.5 million patients over 65 who are admitted to hospitals each year encounter difficulties as a result of delirium.

Among other severe illnesses are OCD and Psychosis.

While there are some issues which are not on disorder level but require attention, like loneliness, sadness, forgetfulness, confusion, complaining of feeling sick more frequently, seeking for attention. If ignored it may also lead to death by suicide.

How can you understand, if someone around you is having mental health issues? Some of the symptoms are discussed as follows:

• Changes in behavior, mood, energy level, or appetite
• Decrease in the intensity of emotions and feeling negative emotions
• Finding it difficult to sleep or sleeping more than usual
• Finding it difficult to concentrate, feeling restless
• Increased worry or feeling stressed
• Anger, irritability, or aggressiveness
• Frequent headaches, digestive issues, or pain
• Misuse of alcohol or drugs
• Feelings of sadness or hopelessness
• Thoughts of death or suicide or suicide attempts
• Engaging in high-risk activities
• Obsessive thinking or compulsive behavior
• Thoughts or behaviors that interfere with work, family, or social life
• Engaging in thinking or behavior that is concerning to others
• Seeing, hearing, and feeling things that other people do not see, hear, or feel

Tips for caregivers:

• Spend time with the elders and ask for their well-being regularly

• Pay attention for any signs of disturbance in their behavior, mood, sleep, and appetite.

• Take help from a mental health professional or online therapist.

• Ask for their opinion in family matters to make them feel important.

• Take them out for dining or meeting friends and family.

Self-care tips for older adults:

• Make sure to eat well, read and learn new tasks as per their interest.

• Take morning and evening walks in nearby park.

• Do not restrict your interest and activity.

• Be part of a social circle

• Share your emotions with someone regularly.

• Do not hesitate to seek out for help.

• Teach, guide and play with children.

• Travel to new places.

• Practice mindfulness meditation.

• Practice spirituality and read spiritual books.

• Stay positive and smile more often.

Life is worth living for people of any age, gender, race, and mental health is part of overall well-being and contributed to the positive self-concept and feeling of integrity over despair.

References:

https://www.mhanational.org/anxiety-older-adults#:~:text=Anxiety%20in%20older%20adults%20may,Overall%20feelings%20of%20poor%20health

https://www.cdc.gov/aging/dementia/index.html#:~:text=Dementia%20is%20not%20a%20specific,a%20part%20of%20normal%20aging.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/

https://www.nimh.nih.gov/health/topics/older-adults-and-mental-health

https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults